DHS consistently show that, especially in sub-Saharan Africa, many women mistakenly assume their husbands disapprove of family planning ( 33, 141, 161, 219). Data from matched husband and wife surveys illustrate the extent of wives' misperceptions. In the Dominican Republic, for instance, 14% of women think their husbands disapprove when, in fact, they approve. Another 8% do not know their husbands' attitudes, but the husbands actually approve (see Figure 4). Such findings suggest that women's unmet need for family planning could by reduced by better communication between husbands and wives.

In Burkina Faso, focus-group discussions with men and women separately found that communication between the sexes about family planning was almost nonexistent. Their lack of communication meant that they frequently misperceived each other's views. "The men thought the women were largely ignorant of family planning, generally opposed to it and in need of education.... The women said the same thing about the men" (161).

A woman's perception of her husband's attitude toward family planning strongly influences whether she will use family planning (33, 141, 219). If a woman thinks that her husband approves of family planning, she is much more likely to use it. In an analysis of DHS data from Kenya, for example, a wife's perception of her husband's approval was more significant in explaining whether or not she used contraception than two other communication variables—discussion between partners about family planning and agreement between spouses about approval of family planning (141). One of the oldest studies on couple communication, done in the 1950s in Puerto Rico, found the same pattern. One-third of the women who did not use family planning said it was because they thought that their husbands disapproved (113).